Browsing by Author "Tombul, T"

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Auditory Brainstem Potentials in Children With Protein Energy Malnutrition
(Elsevier Ireland Ltd, 2005) Odabas, D; Çaksen, H; Sar, S; Tombul, T; Kisli, M; Tuncer, J; Yilmaz, C
Objective: In this study, auditory brainstern potentials (ABPs) were studied in children with protein energy malnutrition (PEM) to determine the effects of PEM on the developing brain in children. Methods: A total of 31 children, aged 3-36 months with moderate/severe PEM and 25 healthy children, aged 3-48 months were included in the study. Nutritional status of the children was assessed by the Gomez classification. Recordings of ABPs were performed by using Nihon Kohden Neuropack 2 device. Results: Of 31 children, 22 (71%) had severe malnutrition, 9 (29%) had moderate malnutrition. Additionally, 8 (26%) and 9 (29%) children had iron deficiency anemia and hypoalbuminemi, respectively. There were significant differences in the mean latencies of the waves I-V on the right and left ears and in the mean interpeak latencies (IPLs) of the waves III-V and I-V on the right ear between the study and control groups (P < 0.05). The mean IPLs of I-V on the left side were found to be longer in the moderate PEM group than those of severe PEM group (P < 0.05). There was not any difference between the groups of PEM with low serum albumin and PEM with normal serum albumin. While the mean IPLs of I-III on the right side were found longer in the cases of PEM without iron deficiency anemia, the mean latency of wave I on the left side, and the mean IPLs of III-Von the right side were longer in the children with PEM plus iron deficiency anemia (P < 0.05). Conclusions: Our findings showed that children with moderate/severe PEM had ABPs abnormalities in different degrees, which reflect defects in myelination of auditory brainstem pathways in children with moderate/severe PEM. However, we found contradictory results between abnormalities in ABPs and degree of malnutrition and iron deficiency anemia. We think that more extensive studies should be performed to determine whether or not there was a relationship between these parameters. (c) 2005 Elsevier Ireland Ltd. All rights reserved.
Brucellosis Incidence in Subjects With Headache in Eastern Turkey
(Dr Dietrich Steinkopff verlag, 2004) Anlar, O; Tombul, T; Akdeniz, H; Kisli, M; Kocturk, F; Caksen, H
Cardiac Involvement in Sydenham's Chorea
(Scandinavian University Press, 1999) Elevli, M; Çelebi, A; Tombul, T; Gökalp, AS
Sydenham's chorea is often encountered in pure form, but it may also occur in association with carditis. Recently, it has been reported that silent, mild valvular regurgitation has been encountered in patients with rheumatic fever manifested by isolated polyarthritis and pure chorea. We studied 22 children with Sydenham's chorea to determine clinical and subclinical heart involvement at the time of the initial diagnosis. Ages of the patients ranged from 6-19 y (mean 13.14 +/- 3.0), and the female/male ratio was 3.4:1. All patients were evaluated by clinical and echocardiographic examination with respect to heart involvement. Carditis was detected in only 5 of 22 patients (23%) by auscultation. Clinical valvular involvement was determined. mitral regurgitation in three and combined mitral and aortic regurgitation in two. The frequency of valvular involvement increased significantly to 63% (14/22) after adding silent mitral regurgitation detected by colour Doppler echocardiography (chi(2) = 7.50, p = 0.0062). We found that clinically inaudible, but echocardiographically significant, mild valvular regurgitation was frequent in patients with pure chorea. It is concluded that colour Doppler echocardiography may be useful in detecting silent valvular regurgitation and in deciding the duration of prophylaxis.
A Case of Melkersson-Rosenthal Syndrome Associated Withehlers-Danlos Syndrome
(Medecine Et Hygiene, 2002) Çaksen, H; Cesur, Y; Tombul, T; Üner, A; Kirmi, E; Tuncer, O; Odabas, D
Melkersson-Rosenthal syndrome (MRS) is characterized by the triad of recurrent facial palsy, lingua plicata, and facial edema. Herein, we report a case of MRS associated with Ehlers-Danlos syndrome due to rare presentation. To the best of our knowledge only one case of MRS associated with Ehlers-Danlos syndrome has been reported in the literature until now.
Comparison of Epileptic and Nonepileptic Cases With Centrotemporal Spikes in View of Clinical Findings and Electroencephalographic Characteristics
(Taylor & Francis Ltd, 2006) Tombul, T; Anlar, Ö; Çaksen, H
The morphological features of centrotemporal spike discharges (CTSD) and relationship of them with clinical diagnosis in cases with benign epilepsy of childhood with centrotemporal spikes (BECTS) and the other epileptic syndromes of childhood as well as some nonconvulsive neurological disorders were detected in the routine patient population who referred to the authors' EEG laboratory. Thirty-six cases (21 males, 15 females; 8 months-14 years old), in which awake and/or sleep EEGs revealed CTSD were included in this study. The cases were divided into two groups as epileptic and nonepileptic. The cases with seizure were divided into BECTS and the other epilepsies. Of the epileptic cases, 14 (38.8%) patients had typical rolandic seizures. In five cases, there were partial or secondary generalized seizures. Two cases had myoclonic seizures. In the nonepileptic group, there was mental retardation/behavioral disturbances in five cases; there were periodic syndromes of childhood such as migraine and equivalents of migraine in three cases; febrile convulsion in three cases, breath-holding spells in two cases, and primary enuresis nocturna in two cases. In the nonepileptic group, the discharges were significantly fewer than the other groups (p = .014). More frequent discharges occuring for shorter periods were more significantly observed in BECTS group (64%). Typically isolated spike and slow-waves in T3/T4 and C3/C4 location were significantly more common (86%) in rolandic epilepsy group (p = .01). The EEGs of cases with BECTS had more frequency in the cluster of discharges than the other groups (p = .018). Multifocal discharges were observed in 28.5% of cases with BECTS, in 20% of nonepileptic group, and in 71.4% of other epileptics in the trial. Although these epileptic and nonepileptic conditions have some differences in view of frequency and morphology and location, CTSDs could be manifested in the group without seizure. It was concluded that the similar focal abnormalities which could be seen in rolandic epilepsy may be observed in the other epileptic or nonepileptic disorders of childhood and this condition may be originated from the involvement of similar central structures.
A Comparison of Heart Rate Variability in Patients With Multiple Sclerosis Undergoing Immunomodulating Therapy or No Such Treatment
(Elsevier, 2005) Tombul, T; Tuncer, M; Eryonucu, B; Anlar, O
Dural Arteriovenous Malformation: a Rare Cause of Epilepsy in Childhood
(Neurol Soc india, 2001) Caksen, H; Unal, O; Tombul, T; Cesur, Y; Abuhandan, M
A 3 year and 6 month old girl with epilepsy associated with dural arteriovenous malformation (DAVM), diagnosed on the MRI, is presented to emphasise the importance of DAVM in the aetiology of childhood epilepsy.
Hemispheric Dominance of Interictal Epileptiform Discharges
(Lippincott Williams & Wilkins, 1999) Tombul, T; Anlar, O; Tanik, O
Hemostatic Markers and Platelet Aggregation Factors as Predictive Markers for Type of Stroke and Neurological Disability Following Cerebral Infarction
(Churchill Livingstone, 2005) Tombul, T; Atbas, C; Anlar, O
We investigated the plasma levels of D-dimer, fibrinogen, beta-thromboglobulin (BTG) and platelet factor-4 (PF-4), indices of the occurrence of platelet activation in vivo, to find out their role in pathophysiology of ischemic stroke and whether or not such a role has any effect on the disability and the prognosis of stroke patients. A total of 76 patients with AIS aged from 26 to 85 (32 men, 44 women) and 30 cases as controls with similar age (18 men, 12 women) were included in the study. The plasma levels of D-dimer, BTG and PF-4 were measured by ELISA method using a special commercial kit. The cases were allocated into two groups as non-embolic (NEI) and cardioembolic stroke (CEI). The D-dimer levels in 76% of 42 patients in NEI group (p < 0.05) and 85.2% of 34 patients in CEI group (p < 0.05) were outside the confidence interval (CI) defined for the control group. The levels of BTG were elevated in 81% of 42 cases with NEI (p < 0.05) and in 76% of 34 cases with CEI, with reference to Cl of control group. The levels of PF-4 were significantly increased in 86% of cases with NEI (p < 0.05) and in 88% of cases with CEI than controls (p < 0.05). It was observed that the cases with high Rankin scores had higher levels of D-dimer (p < 0.005), BTG (p < 0.01) and PF-4 (p < 0.01) than those with lower scores. There was a correlation between hemostatic markers, platelet activation and functional disability. D-dimer levels were an important marker that determined to degree of the activation of hemostatic system, especially in CEI subtype. The platelet aggregation had an important role in pathophysiology of ischemic stroke and this condition is significant in NEI subgroup and subjects with large infarcts and high disability scores. (c) 2005 Elsevier Ltd. All rights reserved.
Interferon-Beta Treatment in Multiple Sclerosis Patients Decreases the Number of Monocytes in Peripheral Blood
(John Wiley & Sons Ltd, 2003) Anlar, O; Tombul, T; Ozbek, H; Dilek, L
Multiple sclerosis (MS) is a demyelinating disease of the central nervous system, characterized by the presence of sclerotic lesions throughout the brain. During clinical activity, monocytes activation markers such as Interleukin 1 and tumor necrosis factor-alpha (TNF-alpha) increase. The effect of interferon beta (IFN-beta) in reducing exacerbation rate and in slowing sustained worsening of disability has been shown in MS. The aim of this study was to determine levels of monocytes percentage in peripheral blood of MS patients receiving IFN-beta. We carried out this study in two groups of MS patients and a group of healthy subjects. First (study) group consisted of 13 patients treated by INF-beta. The control groups consisted of a) 14 MS patients group with no treatment by INF- beta and b) 20 healthy subjects. We counted the percentage of monocytes in the study group before and after one year of treatment by IFN- beta and in the control groups patients in the same period. At the end of one year, there was a significant reduction in the percentage of monocytes in peripheral blood of MS patients treated by interferon.
Left Hemisphere and Male Sex Dominance of Cerebral Hemiatrophy (dyke-Davidoff Syndrome)
(Elsevier Science inc, 2004) Ünal, Ö; Tombul, T; Cirak, B; Anlar, Ö; Incesu, L; Kayan, M
Although radiological findings of cerebral hemiatrophy (Dyke-Davidoff-Masson Syndrome) are well known, there is no systematic study about the gender and the affected side in this syndrome. Brain images in 26 patients (mean aged 11) with cerebral hemiatrophy were retrospectively reviewed. Nineteen patients (73.5%) were male and seven patients (26.5%) were female. Left hemisphere involvement was seen in 18 patients (69.2%) and right hemisphere involvement was seen in eight patients (30.8%). We conclude that male gender and left side involvement are frequent in cerebral hemiatrophy disease. (C) 2004 Elsevier Inc. All rights reserved.
Peripheral Nervous System Involvement in Patients With Beheet's Disease
(Elsevier, 2005) Anlar, O; Tombul, T; Akdeniz, N; Sayin, R; Calka, O; Metin, A
Report of Five Children With Guillain-Barre Syndrome Following a Nationwide Oral Polio Vaccine Campaign in Turkey
(Neurol Soc india, 2003) Anlar, O; Tombul, T; Arslan, S; Akdeniz, H; Caksen, H; Gundem, A; Akbayram, S
Five children with Guillain-Barre syndrome (GBS), following a national oral polio vaccination campaign to eradicate disease, are reported. Clinical examination, cerebrospinal fluid and electromyographic findings conformed to the classical description of GBS. Four of them received therapeutic dose of intravenous immunoglobulin G. Two children succumbed to the disease. It was observed that the number of cases of,GBS in children increased during the period of the oral polio vaccination campaign in Turkey, suggesting a causal relationship.
Restless Legs Syndrome Induced by Mirtazapine
(Physicians Postgraduate Press, 2002) Agargün, MY; Kara, H; Özbek, H; Tombul, T; Ozer, OA
A Review of 35 Cases of Asymmetric Crying Facies
(Medecine Et Hygiene, 2004) Çaksen, H; Odabas, D; Tuncer, O; Kirimi, E; Tombul, T; Ikbal, M; Yuca, SA
A review of 35 cases of asymmetric crying facies: Congenital asymmetric crying facies (ACF) is caused by congenital hypoplasia or agenesis of the depressor anguli oris muscle (DAOM) on one side of the mouth. It is well known that this anomaly is frequently associated with cardiovascular, head and neck, musculoskeletal, respiratory. gastrointestinal, central nervous system, and genitourinary anomalies. In this article we report 35 ACF patients (28 children and 7 adults) and found additional abnormalities in 16 of them (i.e. 45%). The abnormalities were cerebral and cerebellar atrophy, mega-cisterna magna, mental motor retardation, convulsions, corpus callosum dysgenesis, cranial bone defect, dermoid cyst, spina bifida occulta, hypertelorism, micrognatia, retrognatia, hemangioma on the lower lip, short frenulum, cleft palate, low-set cars, preauricular tag, mild facial hypoplasia, sternal cleft, congenital heart defect, renal hypoplasia, vesicoureteral reflux, hypertrophic osteoarthropathy, congenital joint contractures, congenital hip dislocation, polydactyly, and umbilical and inguinal hernia. Besides these, one infant was born to a diabetic mother, and had atrial septal defect and the four other children had 4p deletion, Klinefelter syndrome, isolated CD4 deficiency and Treacher-Collins like facial appearance, respectively. Although many of these abnormalities were reported in association with ACF, cerebellar atrophy, sternal cleft, cranial bone defect, infant of diabetic mother, 4p deletion, Klinefelter syndrome, isolated CD4 deficiency and Treacher, Coll ins like facial appearance were not previously published.
Seasonal and Environmental Temperature Variation in the Occurrence of Ischemic Strokes and Intracerebral Hemorrhages in a Turkish Adult Population
(Taylor & Francis Ltd, 2002) Anlar, O; Tombul, T; Unal, O; Kayan, M
Seasonal and weather influence on the incidence of cerebrovascular disease has been reported previously. The aim of this retrospective study was to determine whether the time of onset of ischemic strokes (IS) and intracerebral hemorrhages (ICH) were associated with the environmental temperature or the time, as a month or season, in our region. We analyzed the monthly and seasonal incidence of stroke between 1997 and 2001. Four hundred and fifty-one cases were admitted to our. clinic (IS; n = 288 and ICH; n = 163), and aged from 16 to 94 years. The study was carried out in province of Van in eastern Turkey. The present study demonstrated a peak occurrence of IS in August (n = 41). For ICH, we observed a peak occurrence in July (n = 23). The highest number of IS occurred in summer (n = 108), the most moderate amount in autumn (n = 81), and the least in spring (n = 38). The hemorrhagic events were hi-hest in summer (n = 58), most moderate in winter (n 61), and lowest in spring (n = 31) and autumn (n = 32). There Was a significantly greater incidence of IS and ICH during the summer than any other season in the province of Van, Turkey. This may reflect the role of weather temperature in the development of stroke and allow us to take preventive measures.
Sleep-Related Violence and Low Serum Cholesterol
(Blackwell Publishing Asia, 2002) Agargun, MY; Sekeroglu, MR; Kara, H; Özer, ÖA; Tombul, T; Kiran, Ü; Selvi, Y
To examine whether there is a relationship between serum cholesterol level and sleep-related violence, we evaluated 15 patients with violent behavior during sleep (VBS) and 15 normal control subjects. The patient and control groups were matched for sex, age, and weight. There were 13 women and two men in each group. The patients with VBS had lower serum total cholesterol, triglyceride, and low-density lipoprotein levels than the healthy subjects. Low cholesterol may effect serotonergic neuronal activity and some types of 5-HT receptors, then may be related to violent behavior during sleep.
Visual Evoked Potential Findings in Behcet's Disease Without Neurological Manifestations
(Taylor & Francis Ltd, 2006) Anlar, O; Akdeniz, N; Tombul, T; Calka, O; Bilgili, SG
Behcet's disease (BD) is a chronic, recurrent multisystem inflammatory disorder firstly described by Turkish dermatologist Dr. Hulusi Beh et in 1937. The classic triad consists of recurrent oral and genital ulcerations and uveitis. The article presents the value of visual evoked potential findings of a series of 44 patients with BD without neurological manifestations seen at the Medical Hospital in Neurology and Dermatology clinics over the past 8 years. The mean latency value of positive peak P100 in BD patients was significantly delayed compared to that of control subjects ( patients's mean: 105.6 ms in right eye and 107.7 ms in left eye; control subject's mean: 101.4 ms in right eye and 101.7 ms in left eye).
Visual Evoked Potentials in Multiple Sclerosis Before and After Two Years of Interferon Therapy
(Taylor & Francis Ltd, 2003) Anlar, O; Kisli, M; Tombul, T; Ozbek, H
Magnetic resonance imaging (MRI) is important in the diagnosis of and follow-up for the treatment of multiple sclerosis (MS); evoked potentials may be important if MRI is normal or cannot be performed. We assessed serial visual evoked potentials (VEPs) and cranial MRI in a group of clinically relapsing-remitting multiple sclerosis (N = 15) treated with interferon beta-lb (INFB-1b) and in normal subjects (N = 15). The investigations were done I week before INFB-lb therapy, 1 year later (N = 15), and 2 years later (N = 10). VEPs were abnormal in most of the patients; MRIs were abnormal in all patients. We used P100 latency as an electrophysiological index for the progress of illness. There were significant differences in VEPs between the beginning and ending of the interferon treatment. We concluded that VEPs would be a reliable index for following up the progress of MS under interferon therapy.